Atsuko Hara writes:

In parts of the developed world only 6 out of 1000 liveborns die before reaching age 5. This is because people in developed countries have many improvements from the first half of 1990s. For example, more money, better nutrition, better medicine and medical care, better sanitation better health facilities (in developing world, only 30-50 %) and higher educational level including basic and medical education.

However, in 16 of the least developed countries the rate is over 200 per 1000 and in developing world a very large number of children are dying every year. More than 12 million children under 5 years of age die in the developing world every year, most from a combination of preventable causes. Especially, developing countries have many problems; micronutrient malnutrition, poor sanitation, deaths from vaccine preventable diseases, etc. Micronutrient malnutrition is estimated to affect at least 2 billion people of ages, but children are particularly vulnerable. Diarrhoeal diseases, mainly resulting from poor sanitation, are responsible for a further 3 million deaths a year among children under age 5 in the developing world. Around 2.4 million children under 5 years are still dying every year from vaccine-preventable diseases; measles, neonatal tetanus, tuberculosis, pertussis,poliomyelitis, diphtheria and so on though child health has improved recently.

What can we members of the Japanese medical community do for these problems ? Of course, the Japanese medical community includes doctors, nurses, medical students, teachers who teach in the medical school. First, we can give the developing countries material help such as medicine, vaccine, medical tools. Owing to vaccine, many children who die from vaccine-preventable diseases might not have to die. Second, we can cooperate in education including medical training and all basic education with people in developing countries. For example, sending Japanese specialists to them, taking in foreign students and so on. Globally, infant mortality has fallen by 25 % since 1980. You can think of many factors. One of the factors is higher educational level of women. The great majority of deaths in the developed world have been avoided if those countries enjoyed the same health and social conditions as the developed nations and had good sanitation. If educational level of women and the others is higher, the health and social conditions and sanitation will become better. Japanese should help educational level of adult women higher by teaching them hygiene such as diets, cleaning, child care, etc and giving them basic medical knowledge such as how to cope with children who catch cold. Anyway, to direct our attention to world health problems is most important, I think.

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